• 제목/요약/키워드: Cut-off Value

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CEA, AFP, CA125, CA153 and CA199 in Malignant Pleural Effusions Predict the Cause

  • Wang, Xin-Feng;Wu, Yan-Hua;Wang, Mao-Shui;Wang, Yun-Shan
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권1호
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    • pp.363-368
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    • 2014
  • Determination of the cause of malignant pleural effusions is important for treatment and management, especially in cases of unknown primaries. There are limited biomarkers available for prediction of the cause of malignant pleural effusion in clinical practice. Hence, we evaluated pleural levels of five tumor biomarkers (CEA, AFP, CA125, CA153 and CA199) in predicting the cause of malignant pleural effusion in a retrospective study. Kruskal-Wallis or Mann-Whitney U tests were carried out to compare levels of tumor markers in pleural effusion among different forms of neoplasia - lung squamous cell carcinoma, adenocarcinoma, or small cell carcinoma, mesothelioma, breast cancer, lymphoma/leukemia and miscellaneous. Receiver operator characteristic analysis was performed to evaluate sensitivity and specificity of biomarkers. The Kruskal-Wallis test showed significant differences in levels of pleural effusion CEA (P<0.01), AFP (P<0.01), CA153 (P<0.01) and CA199 (P<0.01), but not CA125 (P>0.05), among the seven groups. Receiver operator characteristic analysis showed that, compared with other four tumor markers, CA153 was the best biomarker in diagnosing malignant pleural effusions of lung adenocarcinoma (area under curve (AUC): 0.838 (95%confidence interval: 0.787, 0.888); cut-off value: 10.2U/ml; sensitivity: 73.2% (64.4-80.8)%, specificity: 85.2% (77.8-90.8)%), lung squamous cell carcinoma (AUC: 0.716 (0.652, 0.780); cut-off value: 14.2U/ml; sensitivity: 57.6% (50.7-64.3)%, specificity: 91.2% (76.3-98.0)%), and small-cell lung cancer (AUC: 0.812 (0.740, 0.884); cut-off value: 9.7U/ml; sensitivity: 61.5% (55.0-67.8)%, specificity: 94.1% (71.2-99.0)%); CEA was the best biomarker in diagnosing MPEs of mesothelioma (AUC: 0.726 (0.593, 0.858); cut-off value: 1.43ng/ml; sensitivity: 83.7% (78.3-88.2)%, specificity: 61.1% (35.8-82.6)%) and lymphoma/leukemia (AUC: 0.923 (0.872, 0.974); cut-off value: 1.71ng/ml; sensitivity: 82.8% (77.4-87.3)%, specificity: 92.3% (63.9-98.7)%). Thus CA153 and CEA appear to be good biomarkers in diagnosing different causes of malignant pleural effusion. Our findings implied that the two tumor markers may improve the diagnosis and treatment for effusions of unknown primaries.

지역사회 보건 융합에 활용 가능한 노인 운전자용 자가-보고식평가(SAFE-DR)의 타당도 연구 (Validity of the Self-report Assessment Forecasting Elderly Driving Risk (SAFE-DR) Applicable to Community Health Convergence)

  • 최성열
    • 융합정보논문지
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    • 제9권6호
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    • pp.175-182
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    • 2019
  • 본 연구는 노인운전자용 자가 보고식 평가 SAFE-DR 개발 프로젝트의 일환으로 운전위험성 선별을 위한 기준점수를 확인하고 평가의 타당성을 검증하기 위해 수행되었다. Driver 65 Plus평가를 통해 노인운전자 132명을 58명의 위험성 운전자와 74명의 안전성 운전자로 구분하고, 이를 기준으로 SAFE-DR 평가의 위험성 예측 기준을 분석하였다. 또한 SAFE-DR 평가의 구성 타당도, 내용 타당도, 예측 타당도를 검증하였다. SAFE-DR 평가의 운전위험성 예측을 위한 기준점수는 74.5점으로 분석되었으며, 이 기준의 양성 예측도는 88.6%, 음성 예측도는 86.3%로 판별력은 훌륭한(excellent) 수준으로 확인되었다. 또한 집중타당성, 법칙타당성, 내용타당성이 적절한 것으로 판정되었다. 따라서 본 연구를 통해 SAFE-DR은 위험한 노인운전자를 선별하는 용도로 활용할 수 있는 적절한 평가임을 확인하였다.

대사증후군에 대한 사상체질별 허리둘레 및 체질량지수의 절단값에 대한 연구 (Cut-off Values of Waist Circumference and Body Mass Index for Metabolic Syndrome according to Sasang Constitution)

  • 최재완;유준상
    • 사상체질의학회지
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    • 제26권4호
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    • pp.365-378
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    • 2014
  • Objectives This study was performed to investigate the cut-off values of abdominal circumference and Body Mass Index(BMI) according to Sasang Constitution. Methods A total of 1,773 persons, namely 440 male people and 1,333 female people, in ages from 40 to 69 years old, participated in this research. They are all included in the community based Genomic cohort in Wonju in years from 2006 to 2013. The diagnostic criteria of metabolic syndrome was used followed by the National Cholesterol Education Program in Adult Treatment Panel III (NCEP ATP III) and Asian pacific guideline for only abdominal obesity. Results The prevalence of metabolic syndrome was 34.8% for men and 37.6% for women in this research. Taeeumin was the highly significant risk type for the metabolic syndrome in both sexes. Cut-off values of abdominal circumference were 88.3 cm in men, 80.3 cm in women, and cut-off values of BMI were $24.2kg/m^2$ in men and $25.3kg/m^2$ in women. For men, cut-off values of abdominal circumference were 79.5cm in Soyangin, 88.8 cm in Taeeumin and 79.5 cm in Soeumin, and cut-off values of BMI were $23.2kg/m^2$ in Soyangin, $25.6kg/m^2$ in Taeeumin and $20.6kg/m^2$ in Soeumin. For women, cut-off values of abdominal circumference were 76.3 cm in Soyangin, 80.3 cm in Taeeumin and 76.8 cm in Soeumin, and cut-off values of BMI were $22.4kg/m^2$ in Soyangin, $24.9kg/m^2$ in Taeeumin and $21.3kg/m^2$ in Soeumin. Conclusions Although 90 cm in men, 80 cm in women as an Asian pacific guideline were regarded as quite approximate to the mean value of abdominal circumference and $25kg/m^2$ to BMI. But if the results could be allocated in terms of the Sasang constitutional method, the cut-off values for Soyangin and Soeumin should be lowered than now.

선천성 갑상선기능저하증에 대한 신생아 선별검사의 재평가 (Reevaluation of the Neonatal Screening Test for Congenital Hypothyroidism)

  • 강소영;장영표;유지숙
    • Clinical and Experimental Pediatrics
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    • 제48권4호
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    • pp.387-394
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    • 2005
  • 목 적 : 선천성 갑상선기능저하증에 대한 신생아 선별검사결과의 이상빈도는 실제 임상적으로 진단되는 질환의 발생빈도보다 훨씬 높다. 본원에서 시행되는 선천성 갑상선기능저하증에 대한 신생아 선별검사의 위양성률과 소환율을 알아보고 재태기간과 출생체중에 따른 검사결과치를 비교하여 각각의 결과에 따라 cut-off value를 재평가함으로써 임상에서 신생아 선별검사의 결과를 해석하고 질환을 진단하는데 도움을 주고자 하였다. 방 법 : 2000년 5월부터 2003년 1월까지 단국대학교병원에서 출생한 2,133명의 신생아를 대상으로 정상분만의 경우 생후 3일째, 제왕절개인 경우 생후 5일째, 신생아중환자실에 입원한 미숙아인 경우 생후 $14.3{\pm}12.4$일(5-79일) 이내에 신생아의 발뒤꿈치를 천자하여 모세혈을 검사용 채혈지에 묻혀 갑상선자극호르몬과 유리 $T_4$를 효소면역법으로 분석하였고 각각의 기존참고치인 $20{\mu}IU/mL$ 이상, 1 ng/dL 미만일 경우 소아과 외래로 불러 재검하였으며 이때 이학적 검사 및 주산기적 병력, 약물력, 모체질환 등의 여부를 조사하였고 혈청을 이용해 면역형광법에 의한 갑상선기능검사를 시행하였다. 결 과 : 1) 다른 질병이 없었던 1,749명의 갑상선자극호르몬과 유리 $T_4$의 평균${\pm}$표준편차는 각각 $9.01{\pm}5.82{\mu}IU/mL$, $1.99{\pm}0.90ng/dL$이었고 성별, 분만형태, 아프가 점수에 따른 차이는 없었다. 2) 재태연령과 출생체중에 따라 갑상선자극호르몬의 수치는 의미있는 차이가 없었고 유리 $T_4$의 수치는 의미있는 차이가 있었다(P<0.01). 3) 다른 질병이 있었던 384명의 갑상선자극호르몬과 유리 $T_4$의 평균${\pm}$표준편차는 각각 $9.17{\pm}7.22{\mu}IU/mL$, $1.52{\pm}0.75ng/dL$이었고, 건강한 신생아와 비교시 갑상선자극호르몬의 수치는 의미있는 차이가 없었고 유리 $T_4$의 수치는 의미있는 차이가 있었다(P<0.01). 4) 신생아 선별검사에서 131명이 소환되었고 재소환율은 7.48%이었으며, 이중 추적관찰이 가능했던 87명의 갑상선기능이 정상화된 기간은 출생체중과 의미있는 관계는 없었고, 출생주수와는 음의 상관관계를 보였다(P=0.042, Pearson 상관계수 -0.177). 5) 신생아 선별검사에서 재소환되어 선천성 갑상선기능저하증을 진단받은 환아는 모두 4명으로 2명은 갑상선자극호르몬 수치만 $20{\mu}IU/mL$ 이상이었고 2명은 유리 $T_4$ 수치만 1 ng/dL 미만이었으며, 3명은 건강한 신생아에, 1명은 질병이 있었던 군에 속했다. 6) Cut-off value를 본 연구에서 시행되었던 기준인 갑상선 자극호르몬이 $20{\mu}IU/mL$ 이상이거나 또는 유리 $T_4\;1\;ng/dL$ 미만인 경우 소환율, 양성예측률, 민감도, 특이도는 각각 7.48%, 2.29%, 75%, 92.6%이었다. 갑상선자극호르몬이 $20{\mu}IU/mL$ 이상이거나 유리 $T_4\;0.64\;ng/dL$ 미만인 경우에 소환율, 양성예측률, 민감도, 특이도가 각각 4.8%, 3.57%, 75%, 95.3%이었다. 결 론 : 결론적으로 선천성 갑상선기능저하증에 대한 신생아 선별검사에서 갑상선자극호르몬 및 유리 $T_4$ 모두를 선별검사로 사용하는 것은 타당하고, 현재의 cut-off value가 소환율이 높기는 하나 검사의 민감도를 고려할 때 cut-off를 바꾸기에는 문제가 있을 것으로 생각되며 향후 더 큰 대상군을 바탕으로 한 재평가가 필요하리라 생각된다.

수단-목적사슬(Means-End)이론의 컷오프(Cut-off) 수준과 가치 맵(Hierarchical Value Map)의 관계 분석 (Relationship between the HVM and Cut-Off Level of Means-End Chain)

  • 한학진;조문식;오주성;서정모
    • 한국콘텐츠학회논문지
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    • 제11권4호
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    • pp.414-427
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    • 2011
  • 본 연구는 컷오프 수준에 따라 활성화 셀(cell) 수와 래더(ladder) 수 등의 통계량의 변화를 살펴보고, 컷오프 수준의 변화에 따른 가치 맵이 어떻게 변화하는지를 제시하며, 주어진 조건(100명의 응답자에게 최대 5개의 중요한 속성을 선택하도록 하여 가치사슬을 만든 후 이를 이용하여 가치 맵을 그렸을 경우)하에서 정보손실을 최소화하면서 설명력이 있는 최적의 컷오프 수준 결정과 이에 따른 가치 맵을 표현하고자 한다.

효소면역흡착시험을 이용한 경북서부지역의 돼지 흉막폐렴에 대한 항체분포조사 (Survey on the distributions of swine pleuropneumonia antibodies by ELISA in Kyongbuk western area)

  • 서희진;배성수;김대원;김봉환
    • 한국동물위생학회지
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    • 제23권3호
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    • pp.289-299
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    • 2000
  • The study was performed to investigate the distributions of swine pleuropneumonia in Kyongbuk western area by the enzyme-linked immunosorbent assay (ELISA). Sera collected from 400 slaughtered pigs in 3 slaughter houses during the period from May 1999 to october 1999 were tested to detect antibodies against A pleuropneumonie serotype 2 and 5. The optimal dilution of CBE antigen, conjugate and serum for this ELISA were determined 1 : 400, 1 : 20,000, 1 100, respectively. The optimal dilution of OW antigen, conjugate and serum for this ELISA were determined 1 : In, 1 : 20,000, 1 : 200, respectively. Cut-off value in this ELISA was determined by mean absorbance (at 492 nm) of negative control sera added with the triple value of the standard deviation. Cut-off value in ELISA by CBE and OMP antigen were 1.134 and 1.217, respectively. By the ELISA, positive reaction rates to A pleuropneumoniae serotype 2 and 5 for CBE antigen were 38.8% and 18.8%, and for OMP antigen were 42.8% and 23.5% of the 400 samples, respectively.

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Tissue Transglutaminase Antibody and Its Association with Duodenal Biopsy in Diagnosis of Pediatric Celiac Disease

  • Meena, Daleep K.;Akunuri, Shalini;Meena, Preetam;Bhramer, Ashok;Sharma, Shiv D.;Gupta, Rajkumar
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제22권4호
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    • pp.350-357
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    • 2019
  • Purpose: This study aimed to evaluate a possible association between the anti-tissue transglutaminase antibody (anti-tTG) titer and stage of duodenal mucosal damage and assess a possible cut-off value of anti-tTG at which celiac disease (CD) may be diagnosed in children in conjunction with clinical judgment. Methods: This observational study was conducted at a gastroenterology clinic in a tertiary hospital from April 2012 to May 2013. Seventy children between 6-months and 18-years-old with suspected CD underwent celiac serology and duodenal biopsy. Statistical analyses were done using SPSS 16. Diagnostic test values were determined for comparing the anti-tTG titer with duodenal biopsy. An analysis of variance and Tukey-Kramer tests were performed for comparing the means between groups. A receiver operating characteristics curve was plotted to determine various cut-off values of anti-tTG. Results: The mean antibody titer increased with severity of Marsh staging (p<0.001). An immunoglobulin (Ig) A-tTG value at 115 AU/mL had 76% sensitivity and 100% specificity with a 100% positive predictive value (PPV) and 17% negative predictive value (NPV) for diagnosis of CD (p<0.001, 95% confidence interval [CI], 0.75-1). Conclusion: There is an association between the anti-tTG titer and stage of duodenal mucosal injury in children with CD. An anti-tTG value of 115 AU/mL (6.4 times the upper normal limit) had 76% sensitivity, 100% specificity, with a 100% PPV, and 17% NPV for diagnosing CD (95% CI, 0.75-1). This cut-off may be used in combination with clinical judgment to diagnose CD.

적외선 체열 촬영을 이용한 수부냉증 진단의 절단값 산정 (The Cut Off Values for Diagnosing Cold Hypersensitivity of Hands by Using Digital Infrared Thermographic Imaging)

  • 조준영;박경선;이창훈;장준복;이경섭;이진무
    • 대한한방부인과학회지
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    • 제25권3호
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    • pp.95-102
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    • 2012
  • Purpose: The purpose of this study is to define the cut off values of cold hypersensitivity of hands by using digital infrared thermographic imaging(DITI). Methods: Thermographic images of 130 patients with cold hypersensitivity of hands(CHHG, n=65) and non-cold hypersensitivity of hands(NCHHG, n=65) were retrospectively reviewed. We used the temperature difference the palm(PC8) and the upper arm(LU4) for diagnosing cold hypersensitivity of hands. The temperature differences of between two groups were analysed using independent samples t-tests. The cut off values were calculated by ROC curve analysis. Analyses were undertaken using SPSS version 17.0. P value of < 0.05 was considered significant. Results: The temperature difference the palm(PC8) and the upper arm(LU4) were significantly different between groups(p < 0.001). Using receiver operating characteristic curve analysis, the sensitivity, specificity, and area under the curve were 70.8%, 73.8%, respectively both hands. The AUC was 0.822 on right hand and 0.818 on left hand. The optimum cut-off value was defined as $-0.05^{\circ}C$. Conclusions: These results suggest that DITI is a reliable instrument for estimating the cold hypersensitivity of hands.

적외선 체열 촬영을 이용한 안면홍조 진단의 절단값 산정 (The Cut Off Values for Diagnosing Hot flashes by Using Digital Infrared Thermographic Imaging)

  • 조준영;황덕상;이창훈;장준복;이경섭;이진무
    • 대한한방부인과학회지
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    • 제26권3호
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    • pp.85-92
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    • 2013
  • Objectives: The purpose of this study is to find diagnostic points and define the cut off values of hot flashes by using digital infrared thermographic imaging. Methods: Thermographic images of 75 patients with hot flashes (HF, n=35) and non-hot flashes (NHF, n=40) were retrospectively reviewed. We used the temperature difference between Ex-HN3 and CV17, LU4, CV12, CV4 for diagnosing hot flashes. The temperature differences of between two groups were analysed using independent samples t-tests. The cut off values were calculated by received operating characteristic curve analysis. Analyses were undertaken using SPSS version 17.0. and p-value of <0.05 was considered significant. Results: The temperature difference Ex-HN3 and LU4 were the most significantly different between groups (p<0.001). Using receiver operating characteristic curve analysis, the sensitivity, specificity, and area under the curve were 65.7%, 72.5%, 0.729, respectively. The optimum cut off value was defined as $1.00^{\circ}C$. Conclusions: These results suggest that the digital infrared thermographic imaging is a reliable instrument for estimating hot flashes.

탄성초음파에서 유방종괴의 감별진단을 위한 탄성도 점수와 변형비의 유용성 평가 (Evaluation of the Usefulness of Differential Diagnosis of Breast Mass using Elasticity Score and Elasticity Ratio in Elastography)

  • 안현;임인철;이효영
    • 한국방사선학회논문지
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    • 제12권5호
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    • pp.677-682
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    • 2018
  • 본 연구는 유방 전단파 탄성 초음파에서 탄성도 점수와 변형비를 이용한 방법이 양성과 악성병변의 감별진단에 유용한지를 평가하였다. 탄성 초음파를 시행한 224명을 대상으로 하였으며, 유방조직검사 결과를 바탕으로 후향적인 분석을 하였다. 유방 종괴의 양성과 악성에 따른 5단계의 탄성도 점수와의 동질성 비교는 Fisher's Exact test, 변형비와의 차이검증은 Mann-Whitney U test를 실시하였다. ROC 곡선분석을 통해 악성병변의 예측을 위한 탄성도 점수와 변형비의 최적 cut off 값을 결정하였다. 양성과 악성 결절 군의 분류에 따른 탄성도 점수의 동질성 비교와 변형비의 차이검증 결과에서 각각 통계적으로 유의한 차이를 보였으며(p=.000), ROC 곡선분석에서 양성과 악성 결절의 예측을 위한 탄성도 점수와 변형비의 AUC 0.824, 0.806, cut off 값 3, 4.4로 결정되었다(p=.001). 따라서 탄성도 점수와 변형비는 유방 종괴의 감별진단에 도움을 줄 수 있을 것이다.